IMPORTANT - THIS FORUM HAS BEEN REPLACED

We will announce the URL of the new forum here and on the woundsannounce mailing list once it is available. Please be assured that it will have much better paging capabilities than this system, so you won't be left having to wait for a 3/4 Mb file to download!

The 1999-2000 archive is also still available.

Thanks for your support, and hope to see you on the new system.
Pete Phillips

Wound Management Forum

To reduce the clutter and time taken to load this page, old messages are archived in http://www.smtl.co.uk/cgi-bin/HyperNews/get.cgi/wounds-archive.html

Messages

Welcome to the SMTL Wound Management Forum Date: 1999, Sep 20 From: Pete Phillips

Feedback from users of the SMTL web site has overwhelmed our ability to enter into email exchanges with users who ask questions about woundcare. Although we wish to provide free information on our web site, it is not possible for us to provide free consultancy on an individual basis. This discussion forum has therefore been created to allow the discussion of wound management related matters. Please use this forum instead of emailing questions to the webmaster or the editor(s). Email sent to us which would be more appropriately addressed to this forum will be ignored. Don't forget - you can get help on using the HyperNews forum at: http://www.hypernews.org/HyperNews/get/hypernews/instructions.html Enjoy. Pete Phillips, 20th Sept, 1999. Deputy Director of the Surgical Materials Testing Lab

Hospital-based wound clinic Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: 2002, Jan 16 From: Janet M. Davis

Does anyone know of current literature or a book that discusses setting up outpatient clinics, specifically, hospital-based ones? So far, the internet has not been as helpful as I had hoped.

Untitled Re: Hospital-based wound clinic - (Janet M. Davis) Date: 2002, Aug 16 From: <tvn at microsoft.com>

How did you get on with your wound clinic, I am in the process of setting one up and have managed to gleam on publication on the subject and would be happy to assist?!

Untitled Re: Hospital-based wound clinic - (Janet M. Davis) Date: 2002, Oct 04 From: Maggie Bruneau

Untitled Re: Hospital-based wound clinic - (Janet M. Davis) Date: 2002, Oct 04 From: Maggie Bruneau

Developing a wound care inpatient beds for complex elder care. Re: Hospital-based wound clinic - (Janet M. Davis) Date: 2002, Oct 04 From: Maggie Bruneau

I am looking for information on developing a few inpatient beds on a complex continuing care unit for elderly folk with Stage 3 or 4 wounds who cannot be managed in the community or in a LTC environment, but who would return there.

Doppler query Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: 2002, May 08 From: Jill

When performing a doppler on a large lady, a larger cuff was used for the brachial reading, but as the patient found the large cuff uncomfortable for the pedal readings a smaller one was used. Should the same cuff size be used for each (even if using teh smaller cuff size will give artificially high reading)?

mattress replacement Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: 2002, Jul 23 From: Anna

Does anyone have a mattres replacement therapy policy?

How to prevent maceration of the skin? Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: 2002, Aug 30 From: <puppydogstails at hotmail.com>

I am nusring a pt. with 2 ulcers 1 on ball of the foot the other on bottom of the heel. Both are odours, green sloughy and very painful. Duplex scans have ruled out arteial involment but I'm not convinced. The surrounding skin is macerated and coming away in substantial layers. Yet the wound has minimal exudate. How do I manage the maceration?!

response to maceration Re: How to prevent maceration of the skin? - Date: 2002, Oct 25 From: <Ian at Manselltvn.com>

maceration is due to poorly managed exudate by infrequent dressing changes or inappropriate choice of dressing.The primary dressing needs to absorb and lock exudate within the dressing preventing lateral wicking which would eventually return to the skin, and undermine the skins integrity by removing sebum and removing keratonocytes.If the wound is highly exuding a gel(even if it's sloughy) would exacerbate the condition. Simarly a foam, can only retain so much exudate, particularly if the patient is ambulant, and the pressure from walking will force the fluid out of the dressing. A major problem could be the levels of pathogens within the exudate, particularly beta-haemolyitc strep or Pseudomonas Auriginosa. The toxins from the pathogens will further erode the macerated skin causing excoriation. So consider your primary dressing and frequencey of changing. Is the wound infected? would a topical antibacterial product be of use? thats all for now Ian

how to prevent maceration Re: How to prevent maceration of the skin? - Date: 2002, Oct 30 From: clare

In my area we use Cavilon or Sprilon spray around the wound to prevent maceration. Cavilon comes in the form of a barrier cream or spray and Sprilon a spray. They both dry around the outside of the wound, be sure to cover the wound when you spray as it may get into the wound!! Hope this helps, Clare.

some help Re: how to prevent maceration - Date: 2003, Jan 31 From: <philipw at mindspring.com>

keep in mind diabetics affected with foot pressure ulcers that are not healing are 99% of the time infected think staph and pseudemones 1. keep your patient off wieght bearing 2. wounds opened for extended periods of time should be evaluated for osteomyelitis 3.daily dry dressing changes wet wounds =mascerations 4.daily soaks in 1:1 water:plain white vinegear ten minutes although you might find this peculuar my surgical experiance and training from a surgeon in columbia university (NYC) this will cleans the wound from the above mentioned pathogens 5.gentian violet solution on the wounds and its edges works great against mascerations

How can I treat my ulcer? Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: 2003, Mar 26 From: <ag-ed at another.com>

I am a 29 year old nurse and I have an ulcer!It started as a blister on my lower outer calf 3 months ago.I did not bang it or get bitten as far as I know.Once the blister popped, the wound was left with a sloughy edge and a necrotic centre.I have seen 2 Dermatologists and a Medical consultant.I was initially recommened granugel and Allevyn.The wound was slighly infected so I needed to wait for compression.(Dopler indicated venous). I ended up having a mild allergic reaction to almost every dressing I tried(intrasite,granugel,allevyn,granuflex,mefix,opsite). I have now been in compression for 6 weeks.I have had Iodaflex covering the ulcer which has made a big differnce.I have just changed to using Intrasite comformable under the compression yet the surrounding skin is now maccerated.The ulcer itself is low exudate with a tiny amount of slough in the centre yet the area surrounding the slough is a little blue/grey.The macceration is the most painful bit!! The Dermatologist has suggested I may have Pyoderma.I am usually fit and well with no Medical problems.The only thing I may have is Raynauds. Could anyone offer me any advice?!

bioptron light Re: How can I treat my ulcer? - Date: 2003, May 05 From: sarni

Hi there, I'd recommend going under the bioptron light every day for 2 weeks. I've seen miracles with leg ulcers with this treatment.

what??? Re: bioptron light - (sarni) Date: 2003, Oct 29 From: Lynda Fowlie

what theheck is that and where do I get it? LOL

bioptron Re: bioptron light - (sarni) Date: 2004, Feb 17 From: <mignonette at webmail.co.za>

I am looking for feedback on the bioptron device. Does it really work?

Honey for infected wounds Re: How can I treat my ulcer? - Date: Aug 04, 04:01 From: Judie Todd

I am the clinical educator working with a medical honey called Medihoney in Australia. I have had great success using Medihoney on recalcitrant ulcers particularly those that are infected or have become chronic. You require a sterile approved honey for wounds, this is placed on the ulcer once a day if exudating or every 2-3 days if not. Use a non-adherent fione weave gauze impregnated to keep the honey at the wound site then add a secondary dressing such as meesorb. Happy to help if you need further advice.

Need advice Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: 2003, Oct 29 From: Lynda Fowlie

I have suffered with a huge leg ulcer for about 15 years, it started with thrombophlebitis, and blew out 3 valves so they leak all the time.. I have spent 1/3 of my time in an UNA boot and most of the time in a compression sock,and those things help a lot, but the thing I can't get past is the itching, right ater I take the sock off, and the same day that the leg looks like it is gettin better..LOl it will start to itch and almost drive me crazy, then of course I scratch it and it starts all over again, my doctor has never recommended anything to put on my leg except an UNA boot, the only thing that actualy stops the itching is a pail of 118 dere water, yes so hot it makes me sick to my stomach?? Things like POison Ivy treatments work well, but they just further dry out the skin and promote more itching..any advices from you veterans would be appreciated,thanks Lynda

diferences between Biotron light therapy and photo rejuventation? Re: Need advice - (Lynda Fowlie) Date: Jul 31, 04:18 From: Laura

I have heard much of the benefits of Biotron and photo rejuvenation (IPL) but and unsure of the differences in how they work are you able to give me any information on this. do they both have medical applications as well as cosmetic applications? Is one more effective than another for treating skin conditions such as acne, eczema, rosacea, wrinkles, scarring? Kind regards Laura

silver dressings Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: 2004, Feb 08 From: Kim Clemens

Does anyone have experience using silver dressings such as acticoat or aquacel ag or arglaes (medline products) on neonates in the nicu? If so please respond with what your experience has been.

Acticoat Re: silver dressings - (Kim Clemens) Date: Aug 28, 02:04 From: Janice

I am a Wound Care Nurse at a long term care facility. I started using Acticoat 2 months ago and it is very good! I've seen measurable improvement. However, excellent nutrition is extremely important. Checking the albumin level will give you a good start. The product Juven (a powder mixed with water) is a great companion with Acticoat.

Where to buy Juven in UK Re: Acticoat - (Janice) Date: Sep 22, 21:13 From: <jaydou at nextgen.net.mt>

Please could someone tell me where I can buy Juven Nutritional drink in the UK

Silver Nitrate Soaks for leg ulcers - is it safe? - is there evidence? Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: 2004, Feb 13 From: Christine

I wonder if there is any research evidence to support the use of daily 20 minute soaks of silver nitrate on a long standing (6 years) leg ulcer pre dressing. Is there any side effects from using this regime over time. Does anyone have experience of using this regime - good or bad? I look forward to responces With thanks

Untitled Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: 2004, Feb 18 From: <Anonymous>

I noticed a question on estabihment of hospital based Woundcare centers. The APWCA.org site has a listing of such centers and the application has very good questions which actually can be used as examples of what is needed. ie type of specialities and staff, equipment, record keeping etc. feel free to write if you have any further examples lschus at comcast.net

Brand New Forum Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: Apr 30, 08:32 From: Sperry

You can find an attractive and complete new wound care forum, built by a European wound care consultancy company (Wound Caring Projects) on http://www.woundcaringprojects.com/forum/ Good luck

Wound temperature Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: May 28, 19:19 From: Marloes van Kouwen

Hi, Is anyone familiar with taking temperature of a woundbed? I got an infrared thermometer and cannot find any articles on it. I cannot find the brand on the thermometer itself. It only marks: Standard ST-8810 Who can help me? Thank you in advance, Marloes

diabetic foot ulcer Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: Jun 26, 13:22 From: Tania

We are currently trying our best to heal an ulcer located on the outer maleolus of a patients ankle, she came to us with this ulcer. She is allergic to all primary dressings that we have used so far to control exudate e.g Allevyn, granuflex, etc. It did look at one point like it was healing, with good blood supply, evidence of granulation. However, it has broken down again, she has osteomylitis, and diet controlled diabetes, and is also immobile. We are having problems with masceration and now she has mrsa. Currently we are using iodaflex, with non adhesive primary dressing (release)with surgipad and crepe bandage from toe to knee. She is not suitable for VAC, due to the position and state of the wound at present. Can anyone give me a clue as to what we can do to give this wound a correct environment in which to heal. Regards Tania

TX NURSE Re: diabetic foot ulcer - (Tania) Date: Sep 15, 13:04 From: TERRI FRALICK

hello, Oh the frustrations and challenges of the tx nurse. I have a similar problem myself I inherited so to speak. This is what I have done so far. I started him on IV fluids of D51/2ns @ 75cchr c rocephin 1 gm q day x 7 days. They need hydration and helps distribute the antibiotics more prof. ect. I ordered him an air cell matress which he was eligable for. I started him on debreedment c accuzyme aprox a nickel thick c barrier cream to non affected peri wound tissue.Since hes has tendon exp. I use a hydrating sol to that area c xeroform dsg. I am attemping to get him a graft but right now dealing with the infection. His heels should be floated His pre albumin and traditional blood work shoud be done and nutritionist alerted.Pt probably needs up protien in diet. And ofcourse turned q 2 hrs. The wound is washed with some pressure can be poured at a distance or via syrenge but not left wet. Pain management has been initiated. If this person gets up in a wheel chair it should be for a restricted amt of time and or legs elevated. Hope this has been some help.Fellow nurse T.Fralick

Lip Pain - Trumpet Player Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: Jul 08, 09:48 From: Lee

Hi, I am a trumpet player and last night experienced major pain in my lower lip. A small spot like lump appeared on my inner lip and all one side of my lower lip has become inflamed and is very tender to touch. It looks like and feels like a bruise. Will Arnica Cream assist at all, if not is there anything I can use? Thank you Lee

hot metal burns Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: Jul 20, 20:56 From: jackie

I work at a steel works. what is the first aid treatment for hot metal burns.

How long does it take a bruise to turn into an ulcer? Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: Aug 25, 19:32 From: Sheryl Riley

We have a patient with vascular disease who claims he got a bruise on his knee from a car accident, which turned into a non-healing ulcer 6 months later. Is that possible, or was there another injury in that time period? Thanks for the input.

Identifying a Stage II pressure ulcer Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: Aug 28, 02:42 From: Janice

I am new as a treatment nurse and am having a problem with proper identification of skin condition which I am calling a Stage II pressure ulcer. Buttocks with redness and scattered excoriation/abrasions not always over a boney prominence but on the gluteus maximus, caused by friction, shearing, pressure in the bed or w/c; non-compliance with repositioning and possibly not being repositioned enough by the staff. The previous treatment nurse did not identify this as a Stage II Pressure Ulcer and it looks like there is an INCREASE in pressure ulcers. Am I wrong?

grading ulcers Re: Identifying a Stage II pressure ulcer - (Janice) Date: Sep 29, 09:39 From: milsma

this is my first time on the site and either I can't navigate or noone replies to the queries left. I shall attempt to either answer or generate some discussion. The first thing to check is the grading scale you are using. Some class a non blanching erythema as grade one others class it as nought. I imagine it would be useful if you could be clear about what you're assessing and that others with whom you liaise are clear as well. In terms of comaring statistics on prevalence then so long as your definitions are clear you should be ok. Perhaps you could look at this as you identifying more people who may prrogress to develop further skin damage rather than more people developing sores. This is a fairly general response. If you're still there it would be useful to hear back.

Keloids Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: Sep 27, 13:06 From: <homar at ebucksmail.com>

Hi, My wife has 3-4 keloids that have grown large from just pimples. She has coped because they are in unnoticable places. She has had steriod injections as well as cryotherapy. The cryotherapy did flatten the keloid but it made it very white and ugly. She has a 1cm wide by 1mm thick keloid on her face, developed from a pimple. She used a pimple treatment by Clinique which burnt the pimple but made it a scar. It is now growing at a rapid rate. She has had several injections but the keloid grows unabathed. My question is whether the Halean tapes work and if so at which internet shop I could purchase it. She is becoming very dispondent. She also has a cut from the knife of her gynae you know where. As she is getting older the cut seems to tear within and makes her very uncomfortable. Have other women (who have keloids) experienced anything similar. Hoosen, Johannesburg, South Africa. Thanks in advance for your help. D

Info on VAseline in wound care Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: Sep 27, 15:37 From: <Anonymous>

I am keen to find any information on the use of Vaseline/White or yellow soft parrafin in wound care. Particularly whether it can be used on open wounds and if it is licensed for use in wound care at all. Any information would be gratefully recieved. Thanks.

Lymph vessel leaking Re: Welcome to the SMTL Wound Management Forum - (Pete Phillips) Date: Sep 29, 13:24 From: Michelle

Hello, I had a skin cancer removed on my right leg inner calf about 7 weeks ago, most of it has healed but the problem I'am having is that lymph fluid has been leaking out and there is a hole that can't heal because of the lymph fluid making it wet all the time, I have been back to the surgeon twice, at the moment the treatment he has me on is an antibotic powder called Cicatrin then cover with jelonet then a gauge square and then absorbent pad to soak up the leaking lymph fluid then covered with a bandage, I was told four weeks ago it would stop leaking but am finding the hole is slightly getting larger and the lymph fluid increasing, my leg has been elevated firtually for the whole seven weeks,I change the dressing once a day and use saltwater to clean the wound, any advice would be much appreicated Michelle

MRSA and mobility Date: 2001, Jan 25 From: Clint Holland

Please reply to my email address <insurance at insurer.com) I am overseas and wonder if you can help. My wife is in a local hospital with MRSA (Multi) - and got this while being hospitalized for broken bones as a result of a serious car accident. She is presently also suffering PTA (short term memory loss) - and does not know our Daughter was killed in the accident. My question is ;- If not for the MRSA, I could I believe take Susy out for trips to Cinema in her wheelchair (via equipped taxi for such) - which I believe would give her a break from the hospital routine occasionally. But now with the MRSA being diagnosed she is confined to a room but can go to the Hospital garden if away from patients. Besides this she gets 20 minutes or so of psychotherapy a day. Could normally my wife be allowed out of the Hospital to go to Cinema or elsewhere, even though she has MRSA , as my understanding is that she is no threat to visitors or the public , just patients and those in contact with patients. Any general advice on this would be appreciated. I also appreciate Susy should be mentally capable of doing outside trips i.e. not be too stimulated while she is suffering from PTA, but anything is better than being in a small room 24 hours a day with limited contact for long periods with anyone and I simply wonder can be done re outside visits when one has MRSA ? Pls reply to <insurance at insurer.com> Thank you, Clint Holland

Toddler MRSA infection Re: MRSA and mobility - (Clint Holland) Date: 2002, Apr 02 From: Shane Rose

My child had a boil-type lesion come up on the back of his leg which tested positive for MRSA. This child previous to this has been very healthy. The physician put him on Cipro when he came out of the hospital and he seemed to do very well. Two days after completing his antibiotic course he got a very small scratch on his ear and his fever shot up to 104.4 and was taken to the doctor. The doctor was skeptical that the fever was due to MRSA. However, because of my obvious concern he cultured the scratch which again grew out MRSA. At that time he was put on Clindomycin and he has been on this medication for nearly four weeks. Three days ago my father in law, who has very little contact with my son, got a lesion similar to my son's. The doctors were again skeptical that this was MRSA because my father is healthy and has little contact with my son but guess what it grew out MRSA. Now I am concerned because the doctors are unable to tell me how my healthy son who, previous to getting his first lesion, had not been in the hospital in three years and has no other known contacts with MRSA, got MRSA. HELP--Is there a phsyician or group of Physicians who know more about MRSA than my local physician and who are they, how can I get in touch with them---My four year old has been isolated from everyone but his immediate family (brother--who tested negative, sister, father and mother) since January. i need to know how he contracted this and what to do about keeping it gone. please if you have any information forward it to me thank you.

Healthy 15 year old Insulin Dependant Diabetic gets MRSA Septicaemia???? Re: Toddler MRSA infection - (Shane Rose) Date: 2003, Sep 23 From: Julie

Help! Need information on MRSA. My 15 year old son developed MRSA Septicaemia. No previous admissions to hospital. Very healthy prior to this. Ever since this my family have been plagued with abscesses and infected boils which are indicitive of MRSA but our health authority will not give us any answers. My hubby and I both work for the health authority. Please contact me if you can help.

Diets Re: MRSA and mobility - (Clint Holland) Date: 2003, Jan 30 From: Johann-Louise Martin

Dear sir madame i am doing a project on mrsa and i am wondering if you could send me out some information on the diets for mrsa. thank-you! jm

Arnica cream - does it do anything? Date: 2001, Jan 31 From: Ramon Pediani

Has anyone tried arnica cream to relieve the discomfort of subcutaneous infusions?

ARNICA INFO Re: Arnica cream - does it do anything? - (Ramon Pediani) Date: 2002, Nov 23 From: JULIA HAYES

Hello. I too have MRSA, and severe eczema on my hands predominately. I am a Massage therapist, and therefore have and do use various lotions which all have arnica. It seems to acrevate my itching and causes some pain. I wonder if there is any connection?? Good Luck. We need it.

Answer: ARNICA Re: ARNICA INFO - (JULIA HAYES) Date: 2003, Jul 26 From: Daniela C. D.

I´m doing Pharmacy for industrial purpose and maybe I can help you with something that I know: As we know, Arnica has antiinflamatory action, and it will delay the process of healing, because one of the phases of the healing is the inflamatory.

Arnica Re: ARNICA INFO - (JULIA HAYES) Date: 2004, Apr 19 From: <yoginichouhan at btinternet.com>

Arnica is a great healant. used for sports injury on unbroken skin. great for the back when sore. use hot for two minutes followed by cold for two minutes. alternate between hot and cold. finish with hot. helps circulation. this message is from a student of Homoeopathy. Who uses and recommends Arnica. i disagree with all the negative information that has been ditributed.

Looking for Pressure Trauma Prevention risk assessment scales! Date: 2001, Feb 12 From: Rachel McBride

Hi there - I am a staff nurse in an older adult mental health ward and I am trying to research into Pressure Trauma Prevention. At the moment my ward uses the Waterlow Risk assessment scale to measure risk. I would be really grateful if anyone can let me know of other scales that they have found to be effective and / or any research to back this up. Thank-you

Deep wound infection unlikely because __?__ scan was normal. Date: 2001, Feb 14 From: Rocky

What scan would tell a doctor that a deep wound infection was unlikely? The white count was normal, the sed rate was fine, and the ______ scan was completely normal. It sounded like a "sur-tac" or "zeru-tac" scan. It was not stereotactic scan. Can you please help me identify this word that I cannot understand? Thank you, Rocky

Response to "Deep wound infection" Re: Deep wound infection unlikely because __?__ scan was normal. - (Rocky) Date: 2001, Sep 28 From: Daniel S. Toutant, DPM

I beleive the word you are looking for is Ceretek (sp?) as related to the Ceretek Technicium bone scan. This is a 4-phase bone scan where typically a technicium scan is only a 3-phase scan. A typical technicium scan is read 3 times following the introduction of the radioactive marker. Usually immediately, then in 5-10 minutes, and finally after 2 hours. A 4-phase scan adds an additional read after 24 hours.

use of laser in wound healing Date: 2001, Feb 17 From: Daniella

I am currently looking for information relating to the use of gallium arsenide lasers in wound healing. Any references would be appreciated, especially those that discuss specific parameters (dosimetry, pulse frequency, treatment schedules) Thank you, in advance, for your assistance

Untitled Re: use of laser in wound healing - (Daniella) Date: 2001, Jul 17 From: Wayne Naylor

Have a look at this web site on low level laser therapy it may be helpful, they use Gallium Aluminium Arsenide lasers. http://www.omegalaser.co.uk/index.html

More Lasers Re: use of laser in wound healing - (Daniella) Date: 2002, Jan 25 From: Anneke Andriessen

Any one find more companies around? http://www.helbo.co.at/en/therapy/th_therapy.asp Publications on what actually happens? These guys think they're influencing mitochondria... Take care Anneke

laser in wound healing Re: use of laser in wound healing - (Daniella) Date: 2004, Feb 29 From: Jan

I am a physical therapist who has been using laser in wound healing for 10 years with good success. We have a gallium arsenic laser, 140 milliwatts. We are currently facing some opposition from our Best Practice council (rightfully so) due to the lack of evidence based research on this modality. I would love to hear from anyone who has such research results, positive or negative. Thank you.

growth hormones used on acute wounds, Date: 2001, Feb 18 From: mandy

Does anyone have any leads regards growth hormone topical application on acute wounds. I am conducting a literature review on this subject. Any leads would be great thanks.

Larval Therapy Where? Date: 2001, Feb 22 From: Des O`Leary

Hi, I have heard about excellent results with larval therapy on wounds resistant to conventional treatment. Elderly patient has ulcers on soles of feet getting progressively worse despite daily treatment. Anyone know how larval treatment could be obtained in Dublin, Ireland?

university assessment Re: Larval Therapy Where? - (Des O`Leary) Date: 2001, Aug 07 From: amy

hi, im currently studying nursing at the university of newcastle Australia, and i am currently doing an assigment on larval therapy in the treatment of wounds. it would be greatly appreciated if anyone with journal articles or appropriate literatur could maybe contact me at red_may_82 at yahoo.com thanks very much

some clues or other suggestions.. Re: Larval Therapy Where? - (Des O`Leary) Date: 2001, Sep 06 From: kelly drew

Hi there, I don't think that i can help you directly, seeing as i am in canada, however, i wonder if you read the article from WWWounds some time ago. it seemed to me that it was available by prescription. if your doctor did not know, then there may be some other avenues. I am not up to date on your health care system, but here, we have visiting nurses who work for agencies or nursing services. Within those agencies, sometimes, are wound care specialists. or perhaps you could ask at the nearest clinic or hospital about the same. in the meantime have you tried betadine soaks? i am assuming that these wounds are quite mucky, in which case the betadine can help to dry them up and reduce any excess bacteria present. Hope this helps.

Try contacting Steve Thomas !! Re: Larval Therapy Where? - (Des O`Leary) Date: 2001, Nov 24 From: Lee Tomlinson

Hi there, I've used LarvaE therapy a couple of times and it really does work and is so simple to use - converting the rest of the staff is not so simple however!! I'm not sure about the maggots being sent to Dublin but I see no reason why not. They are only available from Wales where Steve Thomas is the main person in the Research Unit. Try this contact Biosurgical Research Unit Bridgend NHS TRust Mid Glamorgan 01656 652 166 01656 752 820 They are very helpful.........good luck Lee

response to Larval Therapy questions Re: Larval Therapy Where? - (Des O`Leary) Date: 2003, Apr 03 From: sharon

I recognize that this is 2 years old, but there may be help for others. Ronald A. Sherman, MD, MSc at Dept of Medicine and Pathology at University Of Calif. Irvine e-mail; RSherman at UCI.edu. He has been very responsive to my inquiries, by phone, fax and email. Helped me write the Policy and Procedure for use of Larvae in my facility. And is the only place in the USA where you can buy medical use larvae.

larvae information Re: Larval Therapy Where? - (Des O`Leary) Date: 2003, Nov 15 From: <elunedmorgan at hotmail.com>

Hi, I am a third year nursing student at the university of wales,Swansea. I am currently writing my dissertation on the use of larvae in wound healing, and the psychological effects involved. I would appreciate any references or web sites which you may have found useful. Thank you.

**PLEASE HELP**. Sucralfate on exudating wounds. . .the truth is out there. . .or at least any evidence? Date: 2001, Feb 27 From: James

A clinical incident has arisen where mis-communication between pharmacist-GP-nurse specialist-community nurse resulted in a service user taking sucralfate orally when the idea originally was for a topical sucralfate preparation. However my query is . . . 'is there there any evidence for the topical use of sucralfate in highly exudating and/or bleeding wounds, in this case malignant melanoma?'I would really appreciate any feedback on this, especially with references. Thanks.

Information on how to apply dressing on different types of wounds including skin tares Date: 2001, Mar 01 From: Diane

Could any body find me any informtion how to apply dressing on different types of wounds from skin tares to pressure sores from grade 1 to grade 5. I would be gratefull if you can give me any help? email me:- dianewhite31.hotmail.com

research into bioptron light therapy Date: 2001, Mar 02 From: Jackie

I am a student nurse looking for research on the Biotron products, polarisation of light and its healing, or these products good or gadget.

bioptron light therapy Re: research into bioptron light therapy - (Jackie) Date: 2003, Dec 29 From: Flo

I am interested in doing research on bioptron light therapy and healing as a paper for the Masters degree. Did you come across any good research?

Indicator research on the Bioptron Light Re: bioptron light therapy - (Flo) Date: Aug 16, 00:15 From: Tom

This is the easiest way to say what I have to say: http://groups.msn.com/provennaturalremedies/bioptronlight.msnw

heart bypass wound healing outside in Date: 2001, Mar 03 From: Lori McCoy

Eight weeks ago my mother underwent extensive heart surgery (3 valves and a double bypass). The chest wound has healed very nicely, however the incision in her upper right thigh where the vein was pulled for the bypass became infected, and now wants to heal from the outside in rather than from the inside out. She has a nurse come twice a day to pack the would with tape. Any suggestions on treatment would be appreciated.

wound care report form Date: 2001, Mar 11 From: Dirk De Wolf

I am searching for examples of woundcare report forms to add to a nurse report. I may set in Exell - format. I am also looking for cd - roms with pics.of wounds. many thanks, dirk.de.wolf at advalvas.be

Optimal concentration of acetic acid against Ps. aeruginosa in wounds? Date: 2001, Mar 12 From: Capelle

After extensive research in the scientific literature I have found no conclusive data on the optimal concentration of acetic acid used in wound dressings against Pseudomonas aeruginosa. Does anyone has positive experiences with the use of acetic acid and what was the concentration used? Does anyone know of the existence of a (placebo) controlled trial? Are ther more side effects known beside the severe stinging in the wound. The minimum inhibitory concentration of acetic acid in vitro has changed over the last 80 years from 0.08% till 2%. Is this phenomenon due to genetic changes in the bacteria or due to changes in the method of analysis? What are the better alternatives for acetic acid beside the use of antibiotics?

ROLE OF NUTRITION IN WOUND HEALING Date: 2001, Mar 14 From: Ted Yeoman

Hi, I'm trying to find a good essay or article on Nutrition & Wound Healing for my site (http://www.yeoman.org.uk). Has any body got anything useful I could either publish, I will give credit (no money but a credit!,) or use as a basis for a rewrite as an essay?

re:nutritional aids to wound healing Re: ROLE OF NUTRITION IN WOUND HEALING - (Ted Yeoman) Date: 2002, Feb 07 From: <Anonymous>

Arginaid is an useful supplement used in our facility with remarkable results. Also, oxandrin is a steroid that is now being used to help nutritional status of wound healing.

Help with an assignment. Re: ROLE OF NUTRITION IN WOUND HEALING - (Ted Yeoman) Date: 2003, Mar 24 From: mary

Hi my name is Mary and I am doing a Degree in Nursing in Co.Derry N. Ireland and was given an assignment on Nutrition and Wound healing and was just wondering if there was any tips or information that you could help me with. The assignment is to examine the evidence based in relation to nutrition and wound healing and explain how I would apply this to my own clinical nursing practce. Thanks.

What Dressing can I use?!! Date: 2001, Mar 15 From: Gai

I have an 83 y/o lady who seems to develope "allergies" to just about every dressing product we use, except gauze. Her skin usually breaks down after using; hydrocolloids, hydrogels,foams, non stick dressings eg, Adaptic and Opsite etc.She has even developed a rash after using combines and also undercast bandaging. She has a small ulcer at present on the medial side of her calf. The vascular surgeon said to use gauze and not to even soak it off but to leave it insitu and cut and trim around the stuck bit and place another piece of gauze on top!! I am confused. Have also tried an alginate, Kaltistat, but the wound was too dry. The peri wound edges always seem to break dowm and the wound gets bigger and bigger. It seems that her skin does not like having moist wound products on it. Help with some ideas on more appropiate dressing products Please !!. from Gai, RN Australia.

Untitled Re: What Dressing can I use?!! - (Gai) Date: 2001, Mar 15 From: Gai

Whoops forgot to mention that she is also allergic to Melolin and related products, not Opsite like I wrote. Have not tried that one, not game!! Gai

DRESSINGS FOR ULCERS Re: What Dressing can I use?!! - (Gai) Date: 2001, Mar 26 From: Josi Kemper

I had the same problem but now I use "NA Ultra" dressings, with Intrasite Gel first, and they NEVER stick or irritate. Josi Kemper

re: what dressing can I use? Re: What Dressing can I use?!! - (Gai) Date: 2001, May 30 From: Catherine

We recently treated small venous ulcers in an elderly lady with the same problem;- reactions to any kind of adhesive dressing, skin breakdown with any type of moist healing environment etc. She was also unable to tolerate compression therapy. After several months of trying a wide variety of products, we applied flamazine q 2 days, covered with a telfa dressing and fastened with a kling bandage. We were delighted when the ulcers healed within a few days of starting the treatment.

aquacel Re: What Dressing can I use?!! - (Gai) Date: 2001, Aug 17 From: Diane

Hello I'm a treatment room nurse at prestwich health centre. I read your message. Have you tried aquacel it is a convatec product (makers of kaltostat)It can be used dry on wet wounds and can be moistened for dry wounds. It is easy to remove.This can be covered with combiderm n it it a non adhesive so hopefully no allergies to adhesive. Has this lady had a doppler assesment Convatec web site is good. Has she had blood tests to rule out underlying aetiologis Diabetes, Thyroid problems etc. Dermatology for patch testing. Convatec is latex free. Hope this helps

cheaper alternative to jelonet for dry soreskin Re: What Dressing can I use?!! - (Gai) Date: 2002, Jun 18 From: libby & jan

could you please assist us with a cheaper wound product for red and dry raw lower leg and foot area. as jelonet is being used and that it is to expencive.

Varicose Ulcers Date: 2001, Mar 18 From: Laurie

I am a carer for an 82 year old gent with varicose ulcers, the GP and district nurse have told us that the only recommended dressing is a pressure bandage. However this causes the gentleman constant pain and great anxiety. Is there an alternative dressing or treatment that could be used? Any help would be greatly appreciated.

question Date: 2001, Apr 25 From: <dharmon at stargtr.net>

Can anyone give me proper instruction for using silver nitrate sticks on a deep abdominal wound? This wound was previously infected and I'm told it must heal from "the inside out". The wound covers a gastric fistula and must close in order for the fistula to remain closed as well. The surgeon went in 3" with the sticks- but I am a bit hesitant to go that far into the abdominal wall. Any advice appreciated. (The patient is my mother and I have some surgical training- so he says I can do this.) Help!!! Email responses to dharmon at stargtr.net THANKS! Jane

any ideas re: chronic non healing surgical wound? Date: 2001, Apr 27 From: <Anonymous>

I am an 42 yo American man with a chronic non healing surgical wound. Below is a brief history---I will provide more detail to anyone that should require same. Please excuse my poor spelling and improper use of clinical terms. The Steadman's is two flights down. In March of 1997 I fell and broke my right fibula and greatly dislocated my right ankle. The seemingly simple orthopedic procedure (a plate on the fib and a distal screw throught the ankle) was met with complications---up to and including osteo-meylitis. Following the first 5 orthpedic surgeries, I was left with a small (2" x 1"---please excuse my metric ignorance) atrophic wound. A 4 week hyperberic treatment was unsuccessful. some 14 months following hyperberics (10/99) I developed a serious soft tissue infection (staph-aureous) at the wound sight. Two extensive i&d's were performed. Two different attempts at skin grafs failed (10/99 and 1/00). Still have a apx 3" x 2" wound now atributed to chronic venal disease---the result of the trauma 9 pieces of surgery and the injury itself. The wound is changed daily using a wet to dry saline dressing. The lower leg is wrapped witha compression bandage (i.e. Ace or similar). No progress so far. Surgery dosen't seem to be a viable option. Complicating matters---this situation has left me out of work for the past 18 months and uninsured---greatly limiting my access to medical care. Any suggestions, comments, ideas would be most appreciated---especially personal protical which I could affect myself. Thanks Gene

Why not try centella asiatica TTFCA or TECA Re: any ideas re: chronic non healing surgical wound? - Date: 2002, Mar 19 From: Mohamed Arif

You can please try oral(capsules or tablets form)of a natural product containing TTFCA or TECA- extract of Centella asiatica and simultaneous topical application of the same in the form of cream or ointment.

also American, are you on Medicaid? Re: any ideas re: chronic non healing surgical wound? - Date: 2002, Aug 24 From: Elizabeth

Gene, I am also American, a PA-C specializing in wound care in the Midwest. Do you have Medicaid or it's equivalent in your state? There are several new options available in the recent months and Medicaid seems to cover quite a few of them. What color is the wound bed? Is it draining? What color is the drainage? Do you know how deep it is? My first recommendation would be to keep it moist, instead of using the wet to dry method. If you'd like to email me, you may email at bnesquared at yahoo.com. best, elizabeth

please check into............................... Re: any ideas re: chronic non healing surgical wound? - Date: 2002, Sep 17 From: penny

Hi, my name is Penny and my daughter kind of knows what you are going through. My daughter had a foot injury, due to a wave runner and had several lacerations in her foot. One of the lacerations ended up with a staph infection in it also. Her doctor ended up having to do surgery and cutting out the infection and any dead skin. She is now planning on having skin grafs done on 9/17/02. I have to tell you if it wasnt for medicaid, i wouldnt know what to do. They can help you with everything from cash, food down to medical. To date they have paid every penny for my daughters medical treatment. Please check into it. It will help and it may give you a little comfort to know that you will be okay. Good luck to you.

Please contact someone that knows wound care....... Re: any ideas re: chronic non healing surgical wound? - Date: 2002, Nov 05 From: Dale

For heaven sakes please contact somone that knows wound care. Wet to dry is ancient care giving to wounds of your type. Is there swelling (edema)? Then a 4-layer compression system is indicated....you need at least 40mmHg compression. Does the wound have heavy drainage? An alginate/foam. Light drainage....an Hydrocoloid..... Somewhat dry...a gel... A two piece compression stocking called Thera Press Duo by Hartmann-Conco may help....easy to remove and put on.... If $ is a problem write back and we will find common alternatives. Sincere Regards, Dale

mrsa???? Re: any ideas re: chronic non healing surgical wound? - Date: 2003, Sep 24 From: Julie

Hello, I would just like to say in reply to your message, you say you had a soft tissue infection "staph aureous" is it M.R.S.A ??? Methycillin Resistant staphlococal Aureous? My son contracted this, he had MRSA Septicaemia. Please contact me if you want more details

med.dr. Re: any ideas re: chronic non healing surgical wound? - Date: 2003, Dec 21 From: richard huget

Pleas try with saliva solution as described at www.huget,de

Battlefield wound management (post debridement). Date: 2001, Jun 26 From: Sally Simmons

I am doing a lit search on battlefield wound management post initial debridement, and wonder if anyone has any articles or original research they could let me have references for ? Sally Simmons [posted on Sally's behalf by Pete Phillips, Webmaster, SMTL]

Brown Recluse Spider Bite, chronic Date: 2001, Jun 28 From: Melissa

To anyone who can help; My name is Melissa and I work in woundcare in a hospital in Springfield, MO. I have a new patient who was bitten by a Brown Recluse Spider 8 years ago. It is now a large black area on the anterior portion of his left lower leg. The wound opens every year, usually in the summer time and it is extremely painful for him. Currently, he is receiving a 10 min whirlpool at 98 degrees Farenhite three times a week. Then, the wound is dressed with polysporin powder and collagenase "santyl" to debride away necrotic tissue. I also do sharp debridement; however, the wound is so painful that he can hardly tolerate this. So far nothing seems to help and I have also read that the venom is temperature dependent so now I wonder if maybe the 98 degree whirlpool is doing him more harm than good. If anyone has any ideas on how to heal this wound PLEASE let me know! My email address is Dnoces78 at AOL.com . Thankyou, Melissa

Untitled Re: Brown Recluse Spider Bite, chronic - (Melissa) Date: 2002, Aug 28 From: <mary.ransbury at verizon.net>

you might try lightly filling the cavity with iodosorb or the flex depending on the drainage. then setopress with the green squares out due to the amount of pain. change it every two days but remove the wrap at noc. somehow it worked for me.

Action Potential Stimulation therapy Date: 2001, Jul 05 From: Belinda Ihaka

Gidday all, I am hoping to find another who uses APS (action potential stimulation) therapy in regards to wound management. Sure this tool can be used to improve general circulation, but I was wondering if anybody has applied this tool locally in regards to wound healing? You may email me privately at the above address. Regards, Belinda Ihaka BHSc(POD)M.N.Z.P.Soc.

Hydrogen peroxide in a sinus wound? Date: 2001, Jul 06 From: Kate Mellor

I have recently had a patient referred from hospital with instructions to irrigate a deep narrow sinus in his foot with 1/2 strength Hydrogen peroxide, then pack with sorbsan soaked in betadine. his other wound on his foot is reasonably clean but overgranulating and we have been asked to apply terra-cortril cream with inadine over! (I have already omitted the peroxide).Comments please.

Collatamp G in a cavity wound - is this appropriate for primary care? Date: 2001, Jul 18 From: Gill Speak

A patient has been treated for a cavity wound on the thigh for about 20 years. For the last 5 years the orthopaedic consultant recommended use of Betadine solution on gauze. The wound remained infected and painful. The DNs expressed concern about the safety and rationale for this, and entered into correspondence about it. Tissue Viability nurse instituted a course of metronidazole gel and tablets, and the regime was changed to Intrasite and Sorbsan. The infection resolved. The consultant is now recommending they use Collatamp G, as they are unwilling to continue with Betadine and gauze. He says he wants to use an antiseptic dressing. Collatamp G is not on Drug Tariff and costs £110 (per dressing?). What are the issues here? Can anyone advise please?

aplegraft Date: 2001, Jul 20 From: <gomeara at juno.com>

Has anyone heard of the use of skin graft called aplegraft. It uses human skin to cover excised skin. Skin is grown from other human skin? My sister-in-law is looking for information on this procedure to determine if it is a viable option for the treatmant of her son's nevus on his hand. Thanks.

Untitled Re: aplegraft - Date: 2001, Jul 23 From: Rand

Have a look at: www.apligraf.com I'm not too optomistic that it would be a solution for a nevus. Best to consult with a competent plastic surgeon for advice.

Sickle Cell Leg Ulcers Date: 2001, Jul 31 From: Janet M. Davis

I have a 51 yr. old female with a 2 yr hx of leg ulcers and hx of sickle cell. The literature I have found has been very limited in the discussion of leg ulcers in sickle cell. If anyone has knowledge or experience with this dastardly problem, please respond. Thanks J M Davis

Article Re: Sickle Cell Leg Ulcers - (Janet M. Davis) Date: 2002, Jan 25 From: Anneke Andriessen

One of the items I googled up. http://www.ohsu.edu/cliniweb/C17/C17.800.893.html There are two links Take care Anneke

menningococcal skin lesions Date: 2001, Aug 03 From: amanda

I am currently undertaking a dissertation for the final part of my degree and I am very interested to hear from other professionals who have cared for patients with menningococcal sepsis and cared for necrotic wounds and skin lesions. I work in a Paediatric Intensive Care and would like to know what other professionals do in caring for these wounds from the very early stages onwards and if you have a protocol in place. Thanks for your attention Look forward to hearing from anyone out there.

Radiodermatitis Date: 2001, Aug 14 From: Ana Cristina Ribeiro Rama

I would like to know if you can informe me about guidelines, protocols or articles for prevention and treatment of radiodermatitis in patients undergowing radiotherapy. Ana Cristina Ribeiro Rama Hospital Pharmacist Manager of Drug Information Service www.simed.org

CPT Codes Date: 2001, Aug 16 From: Lori K

what type of CPT codes are being used for wound care?

topical antibiotics for infected wounds Date: 2001, Aug 16 From: inge teugels

I'm working on an assessment on the use of topical antibiotics in wound infections, especially leg and foot wounds, diabetic wounds. There is little objective data in the literature apart from atricles and research sponsored by pharmacollogical commpanies. Therefore any help (references or advice) is appreciated,on issues like hypersensitivity and resistance. thank you very much for your help, friendly greetings, inge

topical antiseptics Re: topical antibiotics for infected wounds - (inge teugels) Date: 2001, Aug 17 From: Diane

Dear Inge Lineaweaver W, Howard R, Soucy D etal (1985))Topical antimicrobal toxicity. Arch surg 120:267-70 Cameron S, Leaper D (1988) Antiseptic toxicity in open wounds Nurs times 84(25):77 hope this helps

Inquiry Re: topical antibiotics for infected wounds - (inge teugels) Date: 2003, Sep 16 From: Virginia Hill

Need information for a 15 year old wound in front of foot due to accident. Doctors advised amputation, but patient refused. Ligaments were destroyed, but main problem is constant infection. One doctor recommended rerouting blood veins, but lot of fear involved in any operation since leg/foot is slow to heal. Once a doctor applied antibiotic in a paste and infection healed amazingly fast, but can't find that doctor and present doctor could not find information about this.

lux flakes (a blast from the past) Date: 2001, Aug 16 From: paula curtis

can someone help us. We are a district nursing team, whose patients are advised by wound clinics to use lux flakes and a blast from the past for some of us, in that this was used back in the 80's for wound cleansing. What is the research on this? etc or is there research evidence on the viability of it's usage

Untitled Date: 2001, Aug 18 From: barbara

Looking for a support group in the Philadelphia area for unhealing wounds in radiated tissue.

Date: 2001, Aug 21 From: <Anonymous>

Multidisciplinary Woundcare Team Date: 2001, Aug 22 From: Patrick Hennelly, CWS, PT

Would you be so kind as to comment on what you would consider the ideal multidisciplinary woundcare team, how it would receive consults, divide labor between MD/PT/ET and perform outcomes management? Thank you, Patrick Hennelly, PT, CWS Certified Woundcare Specialist Clinical Specialist Physical Therapist University of Virginia Burn and Wound Healing Centers Charlottesville, VA 22908 804-243-6313 pth3x at virginia.edu

Cleansing of chronic foot ulcers Date: 2001, Aug 23 From: Martin Fox

I am reviewing routines around the washing / cleansing of chronic foot ulcers within our NHS Trust with the nurses. Advice to patients varies considerably between individual professionals, from keep the ulcer dry through to wash in a bucket of water with a 'handful of salt'. Some patients have not washed their foot for 18 months. Others routinely use 'salt water', which causes excessive drying of the skin. Using the study by Angeras et al, 1992 (on wasing of leg ulcers in tap water), I would like to suggest we come to a concensus of reasonable routines for all patients with chronic foot ulcers. This would involve them washing the foot and wound perhaps once a week in warm tap water, followed by self dressing (or by a Carer) using a clean technique. Does the forum have any advice or opinions on this aspect of wound care? Regards Martin Fox Podiatrist

WASHING LEG ULCERS Re: Cleansing of chronic foot ulcers - (Martin Fox) Date: 2001, Sep 11 From: <Anonymous>

The ulcer clinic, which I used to attend, used this method. i.e. washing in a bucket of warm water, drawn from a tap, no doubt full of bacteria from the tank in which is was stored. Never did they wash my foot first and those who did not perform this task themselves had their dirty toes and foot also being washed into their ulcer. Therefore, I consider it a very silly method of cleaning an ulcer.

Untitled Re: WASHING LEG ULCERS - Date: 2002, Feb 07 From: brispark

apologies I was not refer to Mr fox but to his first respondent

maybe binliners would help! Re: WASHING LEG ULCERS - Date: 2002, Jun 06 From: student nurse Rose

I have recently completed a placement, working within the community. The washing of leg ulcers has become an issue well talked about amongst community nurses. At present community nurses are advised by infection control that the best current practice is to wash the ulcer using warm tap water in a bowl/bucket lined with a bin liner.The bin liner therefore minimising the risk of cross infection.Emollients may be used on dry areas of skin surrounding the wound bed, but the use of salt I have never heard mentionedWe should as medical professionals protect clients as much as is possible and at present this would appear to be the most appropriate way of protecting clients from infection.

Washing wounds in tap water Re: maybe binliners would help! - (student nurse Rose) Date: 2002, Jun 10 From: <Anonymous>

Warm tap water will almost certainly contain bacteria as it usually comes from a hot water tank. This is how I picked up an infection (I'm almost certain) from this treatment at an Ulcer Clinic.I no longer attend there. I wash it myself with saline solution from sachets. If the water is boiled first and cooled with cold tap water, which is recognised as being safe, this would be better than from a hot water tank.

Another example of careless ulcer washing Re: WASHING LEG ULCERS - Date: 2003, Aug 02 From: Mrs L. Phipps

My elderly mother, whose ulcers were showing encouraging signs of healing, had her ulcerated leg washed at a local ulcer clinic. No lining was put in the bucket and ordinary tap water was used. The foot was not washed first. The result was an infection which seems, over a year later, to be on-going and requires constant courses of anti-biotics. A word of warning to nurses, doctors and ulcer sufferers.

washing wounds Re: WASHING LEG ULCERS - Date: 2004, Mar 10 From: Jackie

Upon the unit where I work we have for some time now cleaned wounds in water as it was felt that saline had no advantages due to the fact it can become contaminated once its in contact with the air. Effective treatment of the wound should ensure that infection is kept to a minimum.

Untitled Re: Cleansing of chronic foot ulcers - (Martin Fox) Date: 2001, Oct 05 From: paula curtis

We have been washing a number of our leg ulcers in warm tap water. This was done after reading the research on tap water and normal saline. Dressing removal was much easier, painfree and comforting to the patient as the warm water is soothing. Why we started the bathing of ulcers in this way was due infact to one of the local wound clinic advice to the patients to soak their legs in warm water with lux flakes. having found no research or literature decided that the best policy was to implement the research we knew and was confident about.

Untitled Re: Cleansing of chronic foot ulcers - (Martin Fox) Date: 2001, Oct 16 From: <tina.chambers at weht.swest.nhs.uk>

Your suggestions certainly fit in with our Trusts Policies and Guidelines.

Pyroderm gangrenosa Re: Cleansing of chronic foot ulcers - (Martin Fox) Date: 2001, Nov 14 From: Kathie

Just wondering if someone can help at all. I have a friend who is suffering from severe Pyroderm Gangrenosa. We are told she is only one of six people in the world with this disease. Unfortunately as we live in Australia knowledge about this is very limited and there is no funding of any kind for mediation or wound dressings. Can anyone help us out with suggestions of methods for changing dressings, what should be used for dressings and also medications. Any supporting evidence would also be appreciated. At this point it is costing here in excess of aud$1,200 per month for medications and dressings. Please help. Kathie

Pyoderma Gangrenosa Re: Pyroderm gangrenosa - (Kathie) Date: 2001, Nov 17 From: Liz Garrood

Hi kathie Not sure if this will be much help, but I am currently looking after someone with this disease and the treatment that has been effective so far is Locoid cream to lesions, covered with Mepitel dressings and gauze pads. Also good steroidal treatment - Prednisolone 20mg daily to reduce inflammation and analgesia such as Co-Dydramol for pain. Over a period of approx 8 weeks the lesions have dried and are starting to granulate nicely, although the underlying GI problem determines that the condition is likely to reflare in the future. Hope this is of some help, Liz

Ulcer adjacent to st